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Risk factors for re...
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Fellström, Bengt,1942-Uppsala universitet,Institutionen för medicinska vetenskaper,The Assessment of LEscol in Renal Transplantation (ALERT) Study Investigators,Fellström, B., University Hospital, Uppsala, Sweden, Department of Medical Science, Renal Unit, University Hospital, Uppsala, Sweden
(author)
Risk factors for reaching renal endpoints in the Assessment of Lescol in Renal Transplantation (ALERT) trial
- Article/chapterEnglish2005
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LIBRIS-ID:oai:DiVA.org:liu-45525
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https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-45525URI
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https://doi.org/10.1097/01.TP.0000147338.34323.12DOI
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https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-104221URI
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Language:English
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Summary in:English
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
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Background. The aim of the study was to identity risk factors for long-term renal transplant function and development of chronic allograft nephropathy (CAN) in renal transplant recipients included in the Assessment of Lescol in Renal Transplantation (ALERT) trial. Methods. The ALERT trial was a randomized, double-blind, placebo-controlled study of the effect of fluvastatin, 40 and 80 mg/day, in renal transplant recipients who were randomized to receive fluvastatin (Lescol) (n=1,050) or placebo (n=1,052) over 5 to 6 years of follow-up. Renal endpoints including graft loss or doubling of serum creatinine or death were analyzed by univariate and multivariate regression analysis in the placebo group. Results. There were 137 graft losses (13.5%) in the placebo group, mainly caused by CAN (82%). Univariate risk factors for graft loss or doubling of serum creatinine were as follows: serum creatinine, proteinuria, hypertension, pulse pressure, time since transplantation, donor age, human leukocyte antigen-DR mismatches, treatment for rejection, low high-density lipoprotein cholesterol, and smoking. Multivariate analysis revealed independent risk factors for graft loss as follows: serum creatinine (relative risk [RR], 3.12 per 100-µM increase), proteinuria (RR, 1.64 per 1-g/24 hr increase), and pulse pressure (RR, 1.12 per 10 mm Hg), whereas age was a protective factor. With patient death in the composite endpoint, diabetes mellitus, smoking, age, and number of transplantations were also risk factors. Conclusions. Independent risk factors for graft loss or doubling of serum creatinine or patient death are mainly related to renal transplant function, proteinuria, and blood pressure, which emphasizes the importance of renoprotective treatment regimens in this population.
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Holdaas, H.Rikshospitalet, Oslo, Norway,the Assessment of LEscol in Renal Transplantation (ALERT) Study Investigators,Univ. Klin. Charité, Berlin, Germany
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Jardine, A.G.University of Glasgow, Glasgow, United Kingdom,the Assessment of LEscol in Renal Transplantation (ALERT) Study Investigators
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Nyberg, G.Sahlgrenska University Hospital, Göteborg, Sweden,the Assessment of LEscol in Renal Transplantation (ALERT) Study Investigators
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Gronhagen-Riska, C.Grönhagen-Riska, C., University Hospital, Helsinki, Finland
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Madsen, S.Skejby Hospital, Aarhus, Denmark
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Neumayer, H.-H.Univ. Klin. Charité, Berlin, Germany
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Cole, E.Toronto General Hospital, Toronto, Ont., Canada
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Maes, B.University Hospital, Leuven, Belgium
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Ambuhl, P.Ambühl, P., University Hospital, Zürich, Switzerland
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Olsson, AndersÖstergötlands Läns Landsting,Linköpings universitet,Hälsouniversitetet,Internmedicin,Endokrin- och magtarmmedicinska kliniken US(Swepub:liu)andol21
(author)
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Staffler, B.Novartis, Basel, Switzerland
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Pedersen, T.R.Preventive Medicine Clinic, Ullevaal University Hospital, Oslo, Norway
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Uppsala universitetInstitutionen för medicinska vetenskaper
(creator_code:org_t)
Related titles
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In:Transplantation79:2, s. 205-2120041-13371534-6080
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Fellström, Bengt ...
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Holdaas, H.
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Jardine, A.G.
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Nyberg, G.
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Gronhagen-Riska, ...
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Madsen, S.
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Neumayer, H.-H.
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Cole, E.
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Maes, B.
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Ambuhl, P.
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Olsson, Anders
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Staffler, B.
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Pedersen, T.R.
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- MEDICAL AND HEALTH SCIENCES
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and Urology and Neph ...
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Transplantation
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Linköping University
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Uppsala University